Skåne Health and Community Advisors SHK Physical and psychological However, through access to information about health and society, and by having Health – a prerequisite health are important factors opportunities to communicate about that impact our abilities to one’s situation in one’s own language, for integration learn new things and poor health can be prevented. participate in civic life. The County Administrative Board, Region Skåne, the Skåne Association of and participation Migration impacts health, as do living Local Authorities, and the municipali- conditions both before, during and after ties of Skåne County have together the move. Groups of newly-arrived refu- developed a unique jointly financed gees show higher inclinations for, for effort in Health and Community Advi- example, stress, heart and circulatory sors, or SHK in Swedish. SHK has an illnesses, diabetes, as well as other important function in welcoming refu- illnesses related to tobacco use. As such, gees to Skåne. The needs and conditions poor health can become an obstacle to of newly arrived immigrants are the ba- one’s ability to integrate into Swedish sis of this effort, which takes place using society. tested and evidence based methods.

Participants in “Self Care” Health and Community Advisors Fact box RÖK stands for the regional agreement Partnership Skåne is a regional plat- in Skåne concerning cooperation among form for methodological development in newly arrived refugees and other immi- Skåne. Make use of knowledge and In 2011, operations were expanded to grants. Participating partners are Region experiences. 20 municipalities in three regional hubs. Skåne, the Swedish Public Employment IHK: International Health Communicators The focus on health was established as a Service, the Skåne Association of Local (name of the effort from 2002 - 2007). SHK originates in the operation that mandatory feature of the program in Authorities, the Swedish Migration Board, was developed by Region Skåne and the Skåne. the Swedish Social Insurance Agency, SHK: Health and Community Advisors (name of the effort since 2008). City of Malmö in 2001 – 2002: Interna- In 2012, operations were expanded to Southern Higher Education, tional Health Informants, later known Nätverk Social Ekonomi Skåne, and the 26 municipalities in four regional hubs. is civic orientation. SO is a manda- County Administrative Board (convenor). SO: as International Health Communica- Also, the regional project Hiv/STI pre- tory element in the establishment plan Skåne’s municipalities are represented tors, or IHK in Swedish. vention was tied to the operation. for refugees since 2010. across the board. In 2008 SHK was created through Part- Aspects of methodological development nership Skåne, and was initially begun are tied to the regional platform for in six municipalities with support from migration and health. The operation has the European Refugee Fund. The focus garnered attention on both national and on health was increased as was focuses as international levels as Best Practice for education and labour market. interventions promoting the health of In 2009, SHK trained communicators refugees and as a positive example of re- for the Somaliland Association in gional cooperation. Malmö. Best Practice In 2010, SHK operated in eleven muni- cipalities. At the end of 2010, the estab- 2006 lishment reform took effect and Civic IHK earned the City of Malmö’s Orientation (SO) became a mandatory integration prize element in the establishment plan for newcomers. SHK adapted its operations 2010 accordingly in addition to profiling the The Somaliland Association earned perspective on health. the City of Malmö’s integration prize 2012 SHK is spread as Best Practice on national and international levels Organisation to reach all Through Partnership Skåne, the opera- SHK operations are tion has been set up within regional developed in a joint hubs in the county. Each of these hubs steering group with has a municipal coordinator responsible the County Adminis­ for coordinating groups within and trative Board and between these hubs. As a result, the regi- Region Skåne as well onal stakeholders today have the unique as in dialogue with opportunity of reaching all new arrivals participating munici­ with health promotion information. palities. The County Administrative Board Hubs (2012): is resposible for the Malmö: management. In addi­ Malmö and . tion, there are reference : groups among participa­ Lund, Eslöv, Kävlinge, Höör, Hörby, ting muni­cipalities and , , and . other collabo­rating stake­ : holders. Helsingborg, , Båstad, Ängelholm, Höganäs, Landskrona, Örkelljunga, , Åstorp, Svalöv, and Klippan. : Kristianstad, Bromölla, , Hässleholm, and Östra Göinge.

Julia Kumbaro, coordinator of the Lund hub, and Ziad Jomaa, coordinator of SHK Program – New In Skåne, we also in Sweden provide health Civic Orientation (SO) is • Coming to Sweden information • Living in Sweden now a law. • Supporting and developing oneself SHK conveys health and social informa- in Sweden Regulations concerning SO Examples of the health modules: tion in the most common languages of • Rights and duties of the individual do not pertain to health • Stress refugees, presently Arabic, Somali, Dari, • Building a family and living with • Alcohol Pashto, and Albanian, or alternatively in children in Sweden promotion and migration- • Women’s health simplified Swedish and English. • Having influence in Sweden related health information. • Men’s health • Caring for one’s health in Sweden • STI/Hiv The information is conveyed through • Aging in Sweden presentations, conversations, exercises, Since regulations concerning civic orien- • Nutrition and Exercise and motivational discussions, with par- tation do not emphasize health promo- • Tobacco ticular attention and adherence to the tion and issues related to migrants’ • Narcotics needs and conditions of new arrivals. health, we have in Skåne chosen to • Allergies supplement the program with this infor- • Dental Care Civic orientation should take place mation. The SHK program follows • Organisation of Health Care in during the first year in Sweden in a pro- legislation with a unique supplement of Sweden gram of at least 60 hours and is to be thematic health modules. Through • Self Care provided through the following thema- SHK’s work, information promoting tic blocks: health is a mandatory part of welcoming Research indicates that information of- new arrivals and interventions for esta- ten must be repeated several times in or- blishment in participating municipali- der to affect people’s lifestyle choices. ties. Through SHK, we make an early in- Therefore, SHK also trains associations vestment in people’s health and the within the field, as well as personnel conditions for participation in Skåne’s within various organisations. In addi- civic life based on the fact that all people tion, SHK operations take place in close have the right to the knowledge necessa- collaboration with other regional devel- ry for making healthy and rational opment programmes for newly arrived lifestyle choices. Assembling the pro- in Skåne, which in turn increases various gram, and methodological development, stakeholders’ knowledge and insight take place in close cooperation with ex- into health’s importance on successful perts and researchers within the field of establishment of refugees. health and migration. Feedback from Zahra Abdi, SHK Somali participants

Via RÖK and Partnership Skåne, there is continual dialogue and feedback about the needs and conditions of refu- gees to the organisations responsible for various issues. By making participant in- fluence possible, we can adapt methods and interventions in order to reach the most effective results. Examples of issues raised include the need for more in-depth information about prevention of tobacco use, dental health, and stress. Also, for example, dia- logue with SHK has resulted in work on developing various methods for recep- tion and inclusion of Somali people. In the Somali Information and Business Centre, newly arrived Somalis receive information and knowledge about health as well as support and education In a democratic society, about entrepreneurship and business. one proceeds from the idea that health is a human right, and that society’s efforts should be adapted to the needs of ”various group. Through SHK’s double cultural competence tied to its particular professional competence in the area, we increase opportunities for newly arrived many times over. The effects This is what of SHK efforts participants say

Through SHK we contribute by provi- ding opportunities for newcomers to: – A woman from Somalia • Know when to seek health care and when to apply self-care in the – A man from Iraq “Now I understand why I home. “What I heard today don’t always obtain medi- • Know where to go when in need for was like a torch in the cation when I am at the health care. district health centre.” • Build increased awareness of dental darkness.” health, the impact of nutrition and the importance of physical activity. • Build increased knowledge of the importance of individually adapted – A man from Lebanon medication. “This was a revolution. What I • Gain insight into the influence of migration on one’s own physical knew about (the hymen) came from and psychological health. culture and tradition. Now I have • Gain knowledge about methods for obtained real knowledge.” preventing and handling stress. • Gain knowledge about methods for quitting smoking. • Gain knowledge about one’s own – A woman from Kosovo – A man from Afghanistan body and how one can protect one- ”Now I understand what passive self from communicable diseases. “They have said it smoking means. Now it will be easier before, but this time to explain to my guests why they I understood what cannot smoke indoors at our home.” they meant.” Financing Kontaktinformation

SHK operations are carried out in • The municipalities - liquid assets SHK Coordinator project form under the auspices of that finance aspects covered in the Ziad Jomaa, Länsstyrelsen i Skåne län RÖK and the developmental platform SO. Tel 040 25 27 39, 0768 47 25 96 of Partnership Skåne. The project is • Region Skåne – liquid assets that [email protected] financed jointly by the stakeholders. finance health modules and the Cooperation between the stakehol­ quality assurance of these themes. SHK Director of Development ders is regulated by contracts. Katarina Carlzén, Länsstyrelsen i Skåne län • The County Administrative Board Tel 040 25 26 59, 0733 92 15 28 finances operational development, employer responsibilities, budget [email protected] and personnel administration as Region Skåne venues, facilities and equipment. Elisabeth Bengtsson, Director of Public Health Tel 040 675 30 68 [email protected]

Read more on the County Administrative Board’s home page

www.lansstyrelsen.se/skane/partnerskapskane Katarina Carlzén, Development Director Birgitta Södertun County Administrative Board of Skåne Regional Advisor, Region Skåne

We aim for good health on equal terms for the entire population. Through the Health and Community Advisors we provide newly arrived immigrants to Skåne with information about conditions they need to learn about issues ”important to good health in their own language.